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Results from the Veterans Health Administration ICD-10-CM/PCS Coding Pilot Study
Shelley Weems1, Pamela Heller2, Susan H Fenton3
1Shelley Weems, RHIA, CCS, is a health information management specialist in the Veterans Health Administration Office of Informatics and Analytics in Washington, DC.
The International Classification of Diseases, Tenth Revision, Clinical Modification and Procedural Coding System (ICD-10-CM/PCS) implementation significantly decreased inpatient coding productivity by 64.5% but only 6.7% for ambulatory care. Coder training and record type impacted these results.
Area of Science:
- Health Informatics
- Medical Coding Systems
- Healthcare Administration
Background:
- The Veterans Health Administration (VHA) prepared for the October 1, 2015, transition to the International Classification of Diseases, Tenth Revision, Clinical Modification and Procedural Coding System (ICD-10-CM/PCS).
- ICD codes are critical for VHA operations, including research, performance measurement, and reimbursement.
- An ICD-10 Learning Lab was established to anticipate operational challenges during this conversion.
Purpose of the Study:
- To evaluate the impact of the ICD-10-CM/PCS conversion on coding productivity within the VHA.
- To quantify the changes in coding efficiency for both inpatient and ambulatory care settings.
Main Methods:
- Data collection was conducted across multiple VHA sites over several months.
- Standardized data collection methods were employed to ensure consistency.
- Productivity metrics were analyzed for inpatient and ambulatory care coders.
Main Results:
- A significant decrease in inpatient coding productivity was observed (64.5%).
- Ambulatory care coding productivity experienced a less substantial decrease (6.7%).
- Factors such as coder training and record type (inpatient vs. outpatient) influenced productivity.
Conclusions:
- The ICD-10-CM/PCS conversion had a more pronounced negative effect on inpatient coding productivity compared to ambulatory care.
- Coder training and the specific coding system (ICD-10-CM vs. ICD-10-PCS) are key determinants of productivity.
- Organizations should conduct site-specific analyses to understand the effects of ICD-10-CM/PCS implementation on their coding productivity.
